Key result
Post-PCI stroke is linked to ~8.4-fold higher 2-year all-cause mortality.
Why the study?
This study was conducted to investigate the clinical characteristics and prognosis of patients who experience stroke after PCI.
Does post-PCI stroke increase all-cause mortality in patients undergoing percutaneous coronary intervention?
Cohort (n=10,724)
Does post-PCI stroke increase all-cause mortality in patients undergoing percutaneous coronary intervention?
Answers are grounded in this paper and cite their sources.
Post-PCI stroke occurs in 1.4% of patients over 2 years and serves as a strong independent predictor of all-cause mortality, particularly following hemorrhagic stroke.
Objective: To investigate the clinical characteristics and prognosis in patients with stroke after percutaneous coronary intervention (PCI). Methods: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI including acute coronary syndrome and stable angina pectoris were enrolled.A two years' follow up was conducted among these patients to investigate the clinical characteristics and prognosis of patients with stroke and of those without. A comparison was done between the two groups. Results: One hundred and forty-five patients had stroke (1.4%) during the follow-up period after PCI, including 124 cases with ischemic stroke (1.2%), out of whom 4 (3.2%) patients died; 21 cases with hemorrhagic stroke, out of whom 9 patients (42.9%) died.There was more female, and more patients with risks factors, hypertension, previous myocardial infarction, previous stroke, etc. in the patients with stroke.During the 2-year follow-up, patients with stroke experienced higher incidence of all-cause mortality (9% vs 1.1%, P<0.000 1). There were no significant differences in the incidences of cardiac death, myocardial infarction, revascularization, stent thrombosis and major adverse cardiovascular event rates between the two groups.COX regression analysis showed that stroke after PCI was associated with the increased mortality (HR=8.387, 95%CI: 4.725-14.855, P<0.000 1). Meanwhile, after propensity score matched analyses (129 pairs), the trend was not changed, and stroke was still an independent risk factor of all-cause mortality (HR=6.737, 95%CI: 1.52-29.85, P=0.012). Conclusions: The patients underwent PCI, who had stroke later, had more clinical risk factors, and more serious degree of atherosclerosis.The incidence of stroke is an independent risk factor for all-cause mortality in patients with coronary heart disease after PCI.
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Tang et al. (2017) conducted a cohort in Coronary heart disease (acute coronary syndrome and stable angina pectoris) undergoing percutaneous coronary intervention (n=10,724). Stroke after percutaneous coronary intervention vs. No stroke after percutaneous coronary intervention was evaluated on All-cause mortality (HR 8.387, 95% CI 4.725-14.855, p=<0.0001). Stroke after PCI was associated with significantly increased 2-year all-cause mortality compared to no stroke (9% vs 1.1%; HR 8.387, 95% CI 4.725-14.855, P<0.0001).
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